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Annals of Surgical Oncology

, Volume 21, Issue 8, pp 2782–2800 | Cite as

Systematic Review and Meta-Analysis Comparing the Surgical Outcomes of Invasive Intraductal Papillary Mucinous Neoplasms and Conventional Pancreatic Ductal Adenocarcinoma

  • Ye-Xin Koh
  • Aik-Yong Chok
  • Hui-Li Zheng
  • Chuen-Seng Tan
  • Brian K. P. Goh
Pancreatic Tumors

Abstract

Objective

The aim of this study was to summarize the current literature comparing the surgical outcomes of invasive intraductal papillary mucinous neoplasms (IPMNINV) and conventional pancreatic ductal adenocarcinomas (PDAC) in order to determine the differences in disease characteristics and prognosis.

Methods

Systematic review of the literature yielded 12 comparative studies reporting the clinicopathological characteristics and overall survival (OS) of 1,450 patients with IPMNINV with 19,304 patients with conventional PDAC.

Results

IPMNINV had a significantly lower likelihood of tumors extending beyond the pancreas [27.6 vs. 94.3 %; T4 vs. T1: odds ratio (OR) 0.111, 95 % confidence intervals (CI) 0.057–0.214], nodal metastasis (45.4 vs. 62.9 %: OR 0.507, 95 % CI 0.347–0.741), positive margin (14.2 vs. 28.3 %; OR 0.438, 95 % CI 0.322–0.596), perineural invasion (49.2 vs. 76.5 %; OR 0.304, 95 % CI 0.106–0.877) and vascular invasion (25.2 vs. 45.7 % OR 0.417, 95 % CI 0.177–0.980) when compared with PDAC. The 5-year OS of IPMNINV was significantly better than PDAC [31.4 vs. 12.4 %: hazard ratio (HR) 0.659, 95 % CI 0.574–0.756]. The tubular subtype had a poorer 5-year OS and demonstrated significantly more aggressive features such as nodal metastases, vascular invasion, and perineural invasion compared with the colloid subtype.

Conclusion

IPMNINV were significantly more likely to present at an earlier stage and were less likely to demonstrate nodal involvement, perineural invasion and vascular invasion. When controlled for stage, IPMNINV had an improved OS when compared with PDAC in the early stages.

Keywords

Overall Survival Vascular Invasion Intraductal Papillary Mucinous Neoplasm Perineural Invasion Tubular Adenocarcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Ye-Xin Koh
    • 1
  • Aik-Yong Chok
    • 1
  • Hui-Li Zheng
    • 2
  • Chuen-Seng Tan
    • 2
  • Brian K. P. Goh
    • 1
    • 3
  1. 1.Department of Hepatopancreatobiliary and Transplant Surgery, Division of SurgerySingapore General HospitalSingaporeSingapore
  2. 2.Saw Swee Hock School of Public HealthNational University of SingaporeSingaporeSingapore
  3. 3.Office of Clinical SciencesDuke-NUS Graduate Medical SchoolSingaporeSingapore

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